The Clinical Coding Policy promotes good practice and consistency of information being produced through the clinical coding process in East London NHS Foundation Trust. It has also been designed to incorporate the requirements of the Data Accreditation process and Data Security and Protection Toolkit to ensure information produced during the coding process is accurate and adheres to local and national policies.
Clinical Coding is the process whereby all diagnoses and procedures for an inpatient episode are converted into internationally used ICD10 diagnosis codes and OPCS4 procedure codes. These codes are converted electronically into a funding category called an HRG code which enables the Trust to invoice commissioners for each patient episode of care. Accurate billing is therefore dependent on accurate clinical coding ,which in turn is dependent on the accuracy and completeness of the clinician’s documentation of the patient’s medical history, diagnoses and procedures carried out during the episode of care.
The Digital Working Policy sets out the Trust’s approach to supporting digital working life. It is high level and generic, covering basic principles. Users should also consult their own professional organisation for guidelines specific to their specialism. Given rapid advances in technology and the constant availability of new products, confirmation should be sought from the Trust’s ICT Department on the latest preferred platforms.
Following annual review no changes have been made to this policy
The Freedom of Information Policy sets out how the Trust meets its obligations in respect of the Freedom of Information Act 2000 and associated codes of practice, in particular the Lord Chancellor’s Code of Practice on records management under Section 46 of the Act, and the Environmental Information Regulations 2004.
Whilst this policy refers essentially to the Freedom of Information Act 2000 (the Act), the principles and standards should also generally be applied to the Environmental Information Regulations 2004 (EIR). Specific advice on EIR should be sought from the Data Protection Officer.
Public authorities have a legal obligation to ensure the provisions of the Freedom of Information Act 2000 and the Environmental Information Regulations 2004 are met. Both have been in force since 1st January 2005 with the intention of promoting greater openness, providing increased transparency of decision making and building public trust and confidence. Both give the public a general right of access to all types of recorded information held by public authorities, including the National Health Service.
The policy has been reviewed for compliance regarding reuse of information.
The Policy and Guidance for Using Bed Rails, Bed Levers and Turning Devices Safely and Effectively. The Bedrails Policy is aimed at staff delivering services on behalf of East London NHS Foundation Trust in both community and inpatient settings. It also covers Community Paediatric Service and specialist services. Bed rails are used extensively in hospitals, care homes and people’s own homes to reduce the risk of bed occupants falling out of bed and injuring themselves It also identifies areas of good practice:
• The need for good communication between bed occupant and carers or staff
• Compatibility of the bed rail, the bed, the mattress and the occupant.
• Correct fitting and positioning of the bed rails initially and after each period of use
• Reassessing for changing needs of the bed occupant
• The need for risk assessment before the provision and use of bed rails.
The MHRA has recently updated the guidance on the management and safe use of bed rails to include learnings from incidents reported and met with relevant organisations and stakeholders to ensure that the updated guidance is widely supported. The policy has been update dated to reflect this and includes;
• The need for risk assessments to be updated regularly. The frequency of reviewing the risk assessment will vary depending on the patient and their circumstances and should be recorded as part of the risk assessment, but will likely be more frequent for children.
• The entrapment risks that trolleys with side rails share with medical beds.
• Additional risks relating to bariatric beds and lateral turning devices.
• The differences between bed rails and bed grab handles and the risks if they are used incorrectly.
• Involving the patient and/or their family or carers in the decision to use bed rails.
• Ensuring that the most up-to-date version of the instructions for use are being used and are provided to the bed occupant and/or their family and carers.
Extensions to existing policies
The Duty of Candour Policy sets out the Trust’s expectations for all Healthcare Professionals and the contractual, statutory and professional responsibility to be honest with patients in their care if things go wrong. The Trust will support staff by fostering a just culture.
This policy applies to all Trust staff at all times; we all have a responsibility for being open, honest and transparent with service users, their families and carers.
Duty of candour applies to all patient safety incidents, which have an actual impact of moderate harm or where a patient safety incident resulted in severe harm, prolonged psychological harm or prolonged pain or death.
The existing Duty of Candour Policy is currently under review and has been extended for 6 months.
The Flood Plan has been established to coordinate management response to the threat of flooding across the Trust. It also aims to provide a structured response to emergencies caused by severe flooding
The objectives of this plan are to
• Set out the responsibilities for planning and management for/of a period of flooding
• To protect life and to defend key facilities
• Set out the business continuity management arrangements during a period of flooding
A review of the existing policy has been undertaken by the Health, Safety, Security & Emergency Planning Manager no significant changes have been identified. The plan has been extended for one year.
The Manual Handling Policy sets out the Trust’s approach to Manual Handling, which essentially aims to protect patients, staff and the general public from the risks arising from manual handling activities; and to comply with legislation, guidance and best practice.
This policy is intended to provide guidance to staff and managers in the organisation in clinical and non- clinical areas to enable the Trust to discharge its statutory obligations under The Manual Handling Operations Regulations (MHOR). The Policy applies to all East London Foundation NHS Trust staff. This policy should be adhered to by staff carrying out manual handling activities, whether handling service users (clinical), or inanimate loads (non-clinical) handling. It applies to all Trust sites both inpatient and out-patient; and to staff working in service users homes, or other community settings such as Day Centres or voluntary settings.
A review of the existing policy has been undertaken by the Health, Safety, Security & Emergency Planning Manager no significant changes have been identified. The policy has been extended for one year.
The Lone Working Policy is aimed at those responsible for managing community services and Lone workers, both on and off Trust premises. It is intended to minimise risks to staff as is reasonably practicable.
Lone Workers may be described as any staff member in any situation, or location who works without a colleague nearby or is out of ‘earshot’/sight of another colleague. This could be outside of a hospital or Trust Unit or, internally, where staff care for patients or service users on their own.
The Policy also gives guidance to Lone Workers and highlights their own responsibilities within this role.
A review of the existing policy has been undertaken by the Health, Safety, Security & Emergency Planning Manager, a request to extend the policy for three months whilst changes are made to reflect People Safe system changes has been approved.
The Complaints Policy provides a robust framework for all staff involved with informal and formal complaints within the Trust, in line with the objectives of the Local Authority Social Services and NHS Complaints (England) Regulations 2009 (The Regulations) and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 16.
This policy and the processes followed by the Trust are also underpinned by the Parliamentary and Health Service Ombudsman (PHSO) Principles of Good Complaint Handling and the Department of Health – Listening, Responding, and Improving: A guide to Better Customer Care (2009) and Healthwatch - Shifting the Mindset January 2020.
A review of the existing policy is currently being undertaken by the Complaints Team, a request to extend this policy for three months has been approved, the policy will be updated to include the outcomes from the Complaints QI Project